One of the top reasons people search for a dentist near them is due to pain caused by their wisdom teeth. Wisdom teeth may be extracted to alleviate discomfort or prevent a future shift in the occlusal positioning of other teeth. The process of extracting a single wisdom tooth may be as quick as a few minutes for a fully erupted maxillary third molar or as long as 45 minutes for complex bony extractions. The cost of a wisdom tooth extraction will largely vary based on the complexity of the case and the estimated amount of time required for the procedure. If a patient is anxious about undergoing a wisdom tooth extraction under local anesthetic, the patient may opt for nitrous oxide (laughing gas) or even general anesthesia. The process of extracting with wisdom tooth should not be painful, but the patient will feel pressure along the gums during the procedure. For a few days following the wisdom tooth extraction, the cheeks are likely to swell near the extraction site due to inflammation. 

Wisdom teeth should usually be extracted by oral surgeons with additional specialty training in complex tooth extractions. The area near the extraction site will initially be numbed with a local anesthetic. Once the extraction site is numb, the oral surgeon has an array of tools to extract the tooth. If the third molar is fully erupted, a dental elevator alone may be sufficient to complete the extraction successfully within a few minutes. The elevator is initially used to go under the gum line and twisted around to loosen the area between the socket and jawbone where the tooth is anchored. After the wisdom tooth is loosened, it will be lifted out of the socket. If it is not possible to remove the tooth using elevators alone, the oral surgeon will complete the procedure using extraction forceps. 

For a fully or partially impacted wisdom tooth, the procedure will take significantly longer. After the extraction site is anesthetized, the oral surgeon will use a surgical knife to cut the gum tissue and access the tooth. Once the incision in the gum tissue is made, the oral surgeon will use a drill to remove any impeding jawbone structure and access the impacted tooth. The process of drilling away the impeding jawbone structure may take 15 minutes or even longer in more complex cases. Once the tooth is accessible, the oral surgeon proceeds to extract the tooth. Before a wisdom tooth extraction is undertaken, a patient’s panoramic x-rays and/or CBCT scans should be comprehensively reviewed to minimize the possibility of paresthesia caused by damaging the inferior alveolar nerve.

After the extraction procedure has started, if the oral surgeon believes that removing the full tooth raises the possibility of paresthesia, the oral surgeon may instead opt for a coronectomy and leave a portion of the tooth along with the root while removing the coronal part of the tooth causing discomfort to the patient. Damage to the inferior alveolar nerve may result in temporary or even permanent numbness in the lips and chin along with possible speech difficulties. 

After a surgical wisdom tooth extraction, it may be necessary to place stitches to minimize the amount of bleeding. Once the extraction is complete, the patient will be instructed to bite down on gauze to create firm pressure around the extraction site until the bleeding is controlled. The oral surgeon will often issue a prescription for ibuprofen or an opioid painkiller to negate the sensation of pain after the anesthetic dissipates. The patient may also be instructed to take a course of antibiotics following an extraction. If postoperative instructions are properly followed, the wisdom tooth extraction site should be fully healed within 2 to 3 weeks.